We don't guess your ACL recovery. We measure it.

Not everyone needs surgery. Some people manage well with rehabilitation alone, particularly if the knee feels stable, there is no significant meniscal damage, and their sport doesn't involve a lot of cutting, pivoting and landing. Others do better with reconstruction. The decision depends on how unstable the knee feels day to day, what else was injured, and what you want to get back to. We will help you work through that with your surgeon rather than push you toward one answer.

Usually somewhere around 12 to 16 weeks, but the week number is not what decides it. Before running we want full knee extension, a settled knee with no persistent swelling, quadriceps strength in the region of 70–80% of your other leg, and the ability to hop and land on that leg with control. Some people meet those criteria earlier and some later. Running before they are met is one of the most common causes of setbacks we see.

For pivoting sports — gymnastics, circus, cheer, dance, football, netball, skiing — the evidence points to nine months at the absolute earliest, and often longer. Studies have found that each extra month of rehab up to around nine months substantially reduces the risk of re-injury.

Timing is one input; passing your testing is the other. We look for limb symmetry above 90% across strength and a hop battery, movement quality under fatigue, and your own confidence in the knee, which we measure rather than guess at.

Limb symmetry index compares your injured leg with your uninjured one, as a percentage. If your injured quad produces 80% of the force of your other side, that is an LSI of 80%.

The usual target before return to sport is above 90% across quadriceps strength, hamstring strength and a series of hop tests. One caveat we always flag: if your uninjured leg has also lost strength during your time off, 90% of a weakened leg isn't the benchmark it looks like — which is why we test both sides against your own baseline and your sport's demands.

At Flexibility Matters, the initial ACL and knee consultation is £125 for 50 minutes, online or at our London Bridge clinic. If ongoing support is the right call, the Monthly ACL Programme is £299 per month and includes weekly 1:1 sessions, a personalised programme, monthly strength and hop testing, and weekday message support. The programme is optional and decided together at your assessment, and you can cancel at any time.

Yes, and a good part of our ACL work is online. Sessions run over video, with testing adapted to equipment you can get to — most commonly a gym. Online works particularly well for people who already train somewhere, and for performers who are touring or away from London. Where hands-on assessment would genuinely change the plan, we will say so and get you in at London Bridge.

Before, if there is time. Going into surgery with a knee that already moves fully and a quad that hasn't shut down is consistently linked to a better recovery afterwards. This is often called prehab. If you have already had your surgery, the next best time to start is now — quadriceps strength lost in the early weeks is the single hardest thing to get back later.

No. You can book directly with us as a self-referring patient. If you are already under a surgeon or consultant, we are happy to liaise with them so your rehab and their plan line up, and we will tell you plainly if we think you need a medical opinion we can't provide.